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Vertebral artery injuries in cervical spine surgery
Gregory D Schroeder1, Wellington K Hsu
1Department of Orthopaedic Surgery, Northwestern University, 676 N. Saint Clair, Suite 1350, Chicago, IL, 60611, USA.
Surgical Neurology International
|December 17, 2013
Summary
Vertebral artery injuries are rare but serious risks during cervical spine surgery. Understanding anatomy, assessment, avoidance, and action is crucial for surgeons to prevent and manage these potential complications.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Orthopedic Surgery
Background:
- Vertebral artery injuries (VAIs) during cervical spine surgery are infrequent but carry significant risks, including fatality.
- A systematic surgical approach is essential for preventing and managing VAIs.
Purpose of the Study:
- To review the risks and management strategies for vertebral artery injuries in cervical spine surgery.
- To emphasize the importance of anatomical knowledge and preoperative planning.
Main Methods:
- This study is a comprehensive literature review.
- Analysis of existing data on vertebral artery injury during cervical spine procedures.
Main Results:
- Upper posterior cervical spine surgeries pose the highest risk for VAIs, while anterior subaxial procedures present the lowest risk.
- Preoperative assessment using CT or MRI is vital due to the vertebral artery's variable anatomy.
- Intraoperative awareness and a clear action plan for hemorrhage control, ischemia prevention, and complication management are critical.
Conclusions:
- Surgeons must master the four A's of VAIs: Anatomy, Assessment, Avoidance, and Action.
- Thorough understanding and application of these principles are mandatory for safe cervical spine surgery.
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